Урология - Urolithiasis

Lesson 4 Urolithiasis

Urolithiasis

The process of forming stones in the kidney, bladder, and/or urethra (urinary tract).

It’s a metabolic disorder, caused by different exogenous and endogenous reasons.

Can be inherited

History

The most ancient stone was founded in mummy buried 7000 years ago.

Morbidity rate is from 0.5 up to 5.3% all over the world.

Aethiology

Exogenous factors:

Climat, biogeochemical structure of soil, chemical properties of water, fluid intake regimen

Labour conditions

Lack of vitamines A and vitamines of B group

Nanobacteria (atyphcal gram-negative bacteria, producing calcium carbonate, are revealed at 97% of all calculi)

Endogenous factors

Local inborn and acquired changes of urinary tract.

One functioning kidney

Vesicoureteral reflux

Infections of urinary tract

Long-time immobilization

Hyperparathyroidism, podagra

Diseases of gastrointestinal tract, liver

Resection of bowel, ileocolic anastamosi

Crone disease

Sarcoidosis, leukemia, metastatic invasion of bones

Increased vit C and A intake

Elevation of GGT and alkaline phosphatase

Physiologic basis of formation kidney and bladder stones is different.

Kidney stones form as a result of physicochemical or genetic derangements leading to supersaturation of the urine with stone-formingsalts or, less commonly, from recurrent urinary tractinfection with ureaseproducing bacteria. Stasis in theupper urinary tract due to local anatomic anomaliesmay also promote or enance stone formation insusceptible individuals.

In contrast, bladder stones form almost exclusively as a result of urinary stasis and/or recurrent infection due to bladder outlet obstruction or neurogenic bladder.